Harmony Healthcare Blog

RCS-1 (Resident Classification System): Significant Change in Status Assessments

Posted by Kris Mastrangelo on Tue, Jul 11, 2017

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


The proposed RCS-1  (Resident Classification System) Payment System is creating waves of questions and comparisons to the existing system. Each element leads to hours of discussion in a rabbit hole type of path.  In true Harmony Healthcare International (HHI) fashion, we like to distill and synthesize without drama or delay.  An important point to address today in preparation for tomorrow is the Significant Change in Status Assessment Criterion. 

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Topics: proposed rule

Resident Classification System RCS-I (Part 2)

Posted by Sally Fecto on Wed, Jul 05, 2017

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


CMS extended the comment period for the recent ANRP the Advanced Notice of Proposed Rulemaking to August 25th, 2017 at 5:00 p.m. This seems to be a good thing seeing the concepts are a little difficult to assimilate. The logic may be sound via data analysis, but is it applicable? 

The below bullets provide added insight into the rationale for said proposed changes, but it appears our gut instincts evoke a certain tinge of uncertainty. 

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Topics: proposed rule, Payment Reform, RCS-I

Arbitration Agreements: Proposed Rule

Posted by Kris Mastrangelo on Wed, Jun 07, 2017

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


In the Fall of 2016, the Requirements of Participation (RoP) included a ruling that caused a significant amount of concern within the Skilled Nursing industry.  The rule 

"prevented facilities from entering into pre-dispute arbitration agreements with any resident or his or her representative or requiring that a resident sign an arbitration agreement a as condition of admission to the LTC facility." 

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Topics: proposed rule, Requirements of Participation

Resident Classification System (RCS-I): Top 14 Points (Part 1)

Posted by Sally Fecto on Thu, May 04, 2017

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


CMS (Centers for Medicare and Medicaid Services) just made available details of the proposed payment system in a document called the Advanced Notice of Proposed Rulemaking.   The document defines the proposed revisions to the currently used Case-Mix Methodology with time for public feedback and opinions on the possibility of replacing the SNF PPS existing Case-Mix Classification Model, Resource Utilization Groups, (RUG-IV) Case Mix Classification Model with the Resident Classification System, Version I (RCS-I). Comments must be received no later than 5 p.m. on June 26, 2017. 

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Topics: proposed rule

Top Ten Points: Proposed Rule for SNFs

Posted by Kris Mastrangelo on Tue, May 02, 2017

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


Last week, the Government announced and published the ideas and concepts for Skilled Nursing Payments for Medicare Part A Beneficiaries effective October 2017 (Fiscal Year 2018).  CMS (Centers for Medicare & Medicaid Services) authored the documents and awaits feedback from the industry.  Upon review of the responses, CMS will adjust and release a Final Rule within approximately 60 days (July 2017)

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Topics: proposed rule

Bundled Payments Are Heart Throbbing

Posted by Melissa Fox on Tue, Aug 02, 2016

The payment reform roller coaster is getting faster and chock-full of surprises!  On July 25, 2016 the Department of Health & Human Services (HHS) released a Proposed Rule for:

  • Cardiac Care: New Bundle payment models for Cardiac Care.
  • Comprehensive Joint Replacement (CJR)-Addendum: An extension of the existing bundle payment model for hip replacements to other hip surgeries.
  • Cardiac Rehabilitation: A new model to increase Cardiac Rehabilitation
  • Pathway for Physicians: A proposed Pathway for Physicians with significant participation in bundle payment models to qualify for payment incentives under the proposed Quality Payment Program.

 

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Topics: CJR, Cardiac Care, proposed rule, Pathway for physicians

Medicare and Medicaid Proposed Rule:  Regulatory Changes for Long-Term Care Facilities

Posted by Joyce Sadewicz on Thu, Nov 19, 2015


On July 13, 2015, the Centers for Medicare and Medicaid Services published a Proposed Rule that revises the requirements for participation in Medicare and Medicaid programs for long-term care facilities. This CMS proposal is due to the fact that as CMS states, “The population of nursing homes has changed, and has become more diverse and more clinically complex.” Evidenced based research has been conducted that has provided greater knowledge about resident safety, health outcomes, individual choice and quality assurance and performance improvement. Major changes have not been made to the conditions for participation since 1991 despite the significant changes to service delivery in this setting.

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Topics: Medicare, Medicaid, proposed rule

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